A M A N I A D I D J A , M D M P H H E A D O F C H I L D A N D N E W B O R N H E A L T H

M O H C A M E R O O N

The GFF PROCESS IN CAMEROON

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Investment Case

Safe Mothers & Newborns Leadership Workshop Nairobi, Kenya, 11th - 16th June 2017

CAMEROON

6/18/17  

q Population:19.4 million inhabitants (RGPH, 2007) q Average annual population growth rate: 2.6% q Median age of the population: 17.7 years q Population under 15 years: 43.6% q Women: 51% of the population. q population living in Extreme poverty : 40 % q Life expectancy :51 years. q National health budget : 5% of the GDP

RMNCAH CHALLENGES

�  MMR: 782 / 100,000 in 2011 (DHS 2011). �  Infant- child mortality remains high in poor parts of the

country,(173 & 154 /1,000 LB) �  Households bear the largest share of health

expenditure: 70.42% �  Insecurity : Boko-Haram �  Quality of care is undermined by limited HR,

infrastructure, poor governance; �  Inter–region equity gap+ intra-region equity gap �  Lack of robust data for decision- making, transparency

and accountability.

WHAT IS THE GFF?

�  Launched in 2015 �  “the key financing platform in support of the UNSG’s

EWEC global movement, with the aim to accelerate efforts to end preventable MNCAH deaths and improve the health and quality of life of women, adolescents and children by 2030

�  Goal: increase resources spent on maternal and child health in 63 of the world’s poorest countries.

� Cameroon is one of the 12 GFF Trust Fund supported countries.

LE  PROCESSUS  D’ELABORATION  DU  DOSSIER  D’INVESTISSEMENT  ET  SON  OPERATIONALISATION  

 

 

 

 

 

 

 

 

 

 

 

 

   

 

 

 

 

 

 

 

 6/  Elaboration  de  la  

cartographie  de  ressources  

11/  Rédaction  du  dossier  d’investissement  

10/  Budgétisation  

12/  Restitution  du  dossier  d’investissement  

7/   Elaboration   des   cadre  logique   et   de   suivi  évaluation,  et  des  activités  

 

8/   Consultation  des  régions  

14/  Adoption  du  dossier  d’investissement  

15/  Rencontres  bilatéraux  d’appui  technique  aux  PTF    et  secteurs  privés  pour    

5.3/   Identification  des   solutions  aux  goulots    

5.2/  Identification  et  analyse  des  goulots  d’étranglement    

 

 

5/Atelier   de   réflexion  technique  6.1   Identification   des  problèmes  et     interventions  à  haut  impact  appropriées  

 

   

4/Réunions   de   plaidoyer  pour  l’implication  technique  de  tous    

3/Analyse   situationnelle    (EQUIST)    

2/   Constitution   des   comités  d’élaboration   et   de   suivi   du  processus    

1/  Ralliement  des  parties  prenantes  et  lancement  officiel    

16/  Rencontres  régionaux  d’assistance  technique    pour  l’opérationalisation  

9/     Atelier   de   consensus  technique     sur   le   cadre  logique,   le   cadre   de   suivi  évaluation,  et  les  activités  

 

 

13/   Rencontres   bilatéraux  de   plaidoyer   avec   le  secteur   privé   et  partenaires  techniques  

 

SUIVI  REGULIER  

DU  PROCESSUS  

FIN  DEBUT  

INVESTMENT CASE DESIGN Preparatory work �  Official Launching of the GFF process at national level �  Validated chronogram for the investment case. �  Coordination platform created and operational �  Priorization workshop held with participation of main

stakeholders (UN, CSO, others public sectors, parliamentarians, Bilaterals, INS, private sectors , mobile phones companies)

�  Inclusive and participative process Review of national data �  Source of data: DHS (2004, 2011), MICS (2011, 2014),

EmONC2015, CRVS, Qualitative studies �  Tools: EQUIST (for RMNCH), One Health

INVESTMENT CASE DESIGN (2/2)

�  Finalize the situation analysis: include adolescent needs assessment, CRVS evaluation

�  Prioritize the interventions �  Develop of the investment case based on the

existing Reproductive, Maternal, Newborn, Child and Adolescent National Strategic plan 2014-2020

�  Costing : Budgeting: One Health Tool

INVESTMENT CASE A comprehensive National RMNCAH Investment Case o  Evidence informed o  Equity-focused and logical o  Main causes of deaths per target group o  Coverage of high impact interventions, o  All this linked with geographic/regional and

urban/rural differences o  Identified interventions by the 3 service delivery

platforms o  Highlight key bottlenecks, causes of bottlenecks

and priority, solutions/strategies

IMPLICATION OF THE PRIVATE SECTOR: THE CASE OF DIB (1/2)

� Development Impact Bond- Results-based financial instrument

� Private investors who agree to subscribe � Gov. make payments if KMC succeed � GCC- Invest C$7 Million by leveraging private

Sector � The Government contribute C$2 M through

the GFF � Donors: MINSANTE, BM / GFF Trust Fund,

GCC, Micronutrient Initiative

IMPLICATION OF THE PRIVATE SECTOR: THE CASE OF DIB (2/2)

�  Funds available in advance; �  Project concentrated in areas of high needs �  Contractual focus on results - # inputs �  Financial returns of investors related to

independently verified results. �  Improved outcomes for low birth weight infants;

Estimate = 4,000 per year �  Comparative Advantage: DIB combines GCC,

GFF, Government, and Cameroon's experience in performance-based financing

�  Launch of DIB in September 2017

CHALLENGES

�  Ensuring a coherent approach in the country: inclusiveness + alignment is needed at country level with different strategic documents;

�  Align the HSS and GFF process timelines, outcomes :that has to be aligned and coherent not only with the SDGs targets but also the country strategic documents.

�  harmonization of indicators , but also the need to be ambitious in other to meet the SDGs goal

LESSONS LEARNED(1/2) �  Improve data quality and completeness

upfront : adolescent health, CRVS, RMNCH sub national data with equity breakdown, and structural barriers

�  Inclusive capacity building on the prioritization tool(EQUIST) accelerated the consensus+ appropriation

�  Prioritizing VS. Compromising. All stakeholders wants their issue to be fully addressed, with disregard of value for money

LESSONS LEARNED (1/2)

� Harmonize the cost categories used both in the budget and in the resource mapping in anticipation of the generation of funding gaps

� A consensus on the logical framework and interventions must be obtained before budgeting is done

CONCLUSION

�  RMNCAH is still a big challenge �  The GFF was a great opportunity

¡  to design and sharpen the health financing policy ¡  Generate discussion and a UHC strategy ¡  To identify and reduce sources of inefficiencies ¡  To design a CRVS strategic plan and reinforce the HIS ¡  to optimize our work with private sector, test innovative

strategies like the DIB for KMC